IMPORTANCE: Endothelial morphometric measures have potential value in predicting graft failure after penetrating keratoplasty. OBJECTIVE: To determine whether preoperative and/or postoperative central morphometric measures (endothelial cell density [ECD], coefficient of variation [CV], and percentage of hexagonality [HEX]) and their postoperative changes are predictive of graft failure caused by endothelial decompensation after penetrating keratoplasty to treat a moderate-risk condition, principally Fuchs dystrophy or pseudophakic corneal edema. DESIGN: In a subset of Cornea Donor Study participants with graft failure, a central reading center determined preoperative and postoperative ECD, CV, and HEX from available central endothelial specular images. SETTING: Cornea Image Analysis Reading Center of the Specular Microscopy Ancillary Study. PARTICIPANTS: Eighteen patients with graft failure due to endothelial decompensation and 54 individuals matched for most donor and recipient measures at baseline whose grafts did not fail. MAIN OUTCOME MEASURE: Change in ECD, CV, and HEX values. RESULTS: Preoperative ECD was not associated with graft failure (P = .43); however, a lower ECD at 6 months was predictive of subsequent failure (P = .004). Coefficient of variation at 6 months was not associated with graft failure in univariate (P = .91) or multivariate (P = .79) analyses. We found a suggestive trend of higher graft failure with lower HEX values at 6 months (P = .02) but not at the established statistical significance (P < .01). The most recent CV or HEX values, as time-dependent variables, were not associated with graft failure (P = .26 and P = .81, respectively). Endothelial cell density values decreased during follow-up, whereas CV and HEX appear to fluctuate without an apparent trend. CONCLUSIONS AND RELEVANCE: Endothelial cell density at 6 months after penetrating keratoplasty is predictive of graft failure, whereas CV and HEX appear to fluctuate postoperatively, possibly indicating an unstable endothelial population in clear and failing grafts. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00006411.
IMPORTANCE: Endothelial morphometric measures have potential value in predicting graft failure after penetrating keratoplasty. OBJECTIVE: To determine whether preoperative and/or postoperative central morphometric measures (endothelial cell density [ECD], coefficient of variation [CV], and percentage of hexagonality [HEX]) and their postoperative changes are predictive of graft failure caused by endothelial decompensation after penetrating keratoplasty to treat a moderate-risk condition, principally Fuchs dystrophy or pseudophakic corneal edema. DESIGN: In a subset of Cornea Donor Study participants with graft failure, a central reading center determined preoperative and postoperative ECD, CV, and HEX from available central endothelial specular images. SETTING: Cornea Image Analysis Reading Center of the Specular Microscopy Ancillary Study. PARTICIPANTS: Eighteen patients with graft failure due to endothelial decompensation and 54 individuals matched for most donor and recipient measures at baseline whose grafts did not fail. MAIN OUTCOME MEASURE: Change in ECD, CV, and HEX values. RESULTS: Preoperative ECD was not associated with graft failure (P = .43); however, a lower ECD at 6 months was predictive of subsequent failure (P = .004). Coefficient of variation at 6 months was not associated with graft failure in univariate (P = .91) or multivariate (P = .79) analyses. We found a suggestive trend of higher graft failure with lower HEX values at 6 months (P = .02) but not at the established statistical significance (P < .01). The most recent CV or HEX values, as time-dependent variables, were not associated with graft failure (P = .26 and P = .81, respectively). Endothelial cell density values decreased during follow-up, whereas CV and HEX appear to fluctuate without an apparent trend. CONCLUSIONS AND RELEVANCE: Endothelial cell density at 6 months after penetrating keratoplasty is predictive of graft failure, whereas CV and HEX appear to fluctuate postoperatively, possibly indicating an unstable endothelial population in clear and failing grafts. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00006411.
Authors: J H Lass; W J Reinhart; W E Bruner; M L Kachmer; M D Lomeo; K M Morgan; I Glavan; D R Sanders Journal: Ophthalmology Date: 1989-05 Impact factor: 12.079
Authors: J H Lass; W J Reinhart; D L Skelnik; W E Bruner; R P Shockley; J Y Park; D L Hom; R L Lindstrom Journal: Ophthalmology Date: 1990-01 Impact factor: 12.079
Authors: Naomi Joseph; Chaitanya Kolluru; Beth A M Benetz; Harry J Menegay; Jonathan H Lass; David L Wilson Journal: J Med Imaging (Bellingham) Date: 2020-02-14
Authors: Mohamed Abou Shousha; Sonia H Yoo; Mohamed S Sayed; Sean Edelstein; Matthew Council; Ravi S Shah; Joshua Abernathy; Zachary Schmitz; Patrick Stuart; Rocio Bentivegna; Maria P Fernandez; Christopher Smith; Xiaotang Yin; George J Harocopos; Sander R Dubovy; William J Feuer; Jianhua Wang; Victor L Perez Journal: Am J Ophthalmol Date: 2017-03-02 Impact factor: 5.258